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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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I have been experiencing very intense anxiety for the last

Customer Question

I have been experiencing very intense anxiety for the last 3 years and go to a psychiatrist. I take lorazepam which helps the panic and general anxiety quite a bit. The biggest issue right now is agoraphobia. I can only leave my house several hours a day.

I tried citalopram 2 years ago and had awful anxiety from it. That was from 1/3 of a pill. I also tried 100mg niacinamide; that led to excess energy and couldn't sleep till 5am.

My doctor friend (not my pscychiatrist) recently prescribed me Bupropion. I would start slow and build up to 50mg x 2 daily. But I'm reading lots of negative reviews for Bupropion for anxiety. Do you think it's a mistake to try Burpropion for anxiety? If so, what would be a better alternative to try?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help.

Elliott, LPCC, NCC :

Do you get panic attacks (rapid heartbeat, struggle to catch your breath, other symptoms)?

Elliott, LPCC, NCC :

It is often associated with Agoraphobia.

Customer:

Less now that I'm on lorazepam.

Customer:

agoraphobia is the biggest problem i'm having now. can only leave house several hours a day

Customer:

Get flu like symptoms if I try to leave more than that

Elliott, LPCC, NCC :

Lorazepam is good for General Anxiety Disorder (GAD) but not for Panic Attacks. Agoraphobia is often related to fear of being outside in case you get panic attacks or high anxiety.

Customer:

What meds are good for agoraphobia?

Elliott, LPCC, NCC :

Lorazepam is a benzodiazepine. A better one might be alprazolam (Xanax) which comes on faster and stays in your body for a shorter time, and you can (and should) take it only as needed. All benzos can be addictive. but taken as needed in a limited way are fairly safe.

Elliott, LPCC, NCC :

Bupropion is an antidepressant and antianxiety drug that I think is the most preferable. It takes several weeks to start to work as do most antidepressants.

Elliott, LPCC, NCC :

It is NOT an SSRI but in its own class.

Elliott, LPCC, NCC :

Unlike most other ADs it does NOT cause weight gain and does not cause sexual dysfunction (loss of libido).

Customer:

So you think Bupropion is good to try for my anxiety based on my initial question?

Elliott, LPCC, NCC :

Unless you have epilepsy or other disorders making you prone to seizures, it is a preferable drug, in my estimation and if I needed one in your position that would be he one I would take.

Elliott, LPCC, NCC :

Usual starting dosage is 150 mg and it can go up to 350mg per day according to recommended guidelines.

Customer:

I would start much less (like 10, 20, etc) to see how I react. I'm in no rush and do not want to experience anything too intense.

Customer:

How about 5HTP. You think that's a good supplement to try later if Bupropion doesn't work for me?

Elliott, LPCC, NCC :

If your doctor is going to take you off Citalopram then you should be weaned over several months as you build up the bupropion.

Elliott, LPCC, NCC :

A small dose like you mentioned will not do anything for you other than see if you are allergic to it (which is rare) but it will not help you in that amount if the initial starting dose is 150 mg.

Customer:

citazlopram was just 1 pill two years ago. I take lorazepam 3 times a day for 3 years now. I will not get off lorazepam. WHen I take Bupropion it will be in addition to lorazepam.

Elliott, LPCC, NCC :

You can take them together.

Customer:

how about 5HTP. is that something to try later?

Elliott, LPCC, NCC :

You will get very sick if you try to quit the lorazepam and at that rate you may be addicted to it.

Customer:

No plan to stop taking lorazepam. Eventually I will wean off very slowly. But I plan to take lorazepam and bupropion each day.

Elliott, LPCC, NCC :

Don't mix 5HTP with other antidepressant drugs as it can raise your serotonin level too high. It is an over the counter supplement and not as strong as a prescription med.

Customer:

It would be lorazempam and 5HTP later if bupropion doesn't work well for me. Not a good mix?

Elliott, LPCC, NCC :

If the bupropion starts to help you then you should wean off the lorazepam under strict supervision. It should take about 6 months to wean off safely.

Elliott, LPCC, NCC :

5HTP will mix with lorazepam without high risk.

Customer:

shouldn't take lorazepam and bupropion long term together?

Customer:

Ok. You have been very helpful. Thank you very much!!!

Elliott, LPCC, NCC :

I wish you great success and shall keep you in my prayers.

Elliott, LPCC, NCC :

Warm regards,

Elliott, LPCC, NCC :

Elliott, MAE, LPCC, NCC, CCMHC

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and 3 other Mental Health Specialists are ready to help you
Expert:  Elliott, LPCC, NCC replied 1 year ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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Expert:  Elliott, LPCC, NCC replied 1 year ago.
Dear Chris,

Thank you. May God bless and protect you.

Elliott

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